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Weisberg DB, Leuer J, McClenaghan J, Yu JH, Wehner W, McLaughlin K, Abrams T, Barr J, Grierson B, Lyons B, MacDonald JR, Meneghini O, Petty CC, Pinsker RI, Sinclair G, Solomon WM, Taylor T, Thackston K, Thomas D, van Compernolle B, VanZeeland M, Zeller K. An Integrated Design Study for an Advanced Tokamak to Close Physics Gaps in Energy Confinement and Power Exhaust. Fusion Science and Technology 2023. [DOI: 10.1080/15361055.2022.2149210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- D. B. Weisberg
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - J. Leuer
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - J. McClenaghan
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - J. H. Yu
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - W. Wehner
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - K. McLaughlin
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - T. Abrams
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - J. Barr
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - B. Grierson
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - B. Lyons
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - J. R. MacDonald
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - O. Meneghini
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - C. C. Petty
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - R. I. Pinsker
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - G. Sinclair
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - W. M. Solomon
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - T. Taylor
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - K. Thackston
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - D. Thomas
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | | | - M. VanZeeland
- General Atomics, PO Box 85608, San Diego, California 92186-5608
| | - K. Zeller
- General Atomics, PO Box 85608, San Diego, California 92186-5608
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Landry S, Barr J, MacDonald M, Hamilton G, Mansfield D, Edwards B, Joosten S. P057 Virus aerosol propagation by CPAP is proportional to mask leak and can be prevented by use of a hood and air filtration system. SLEEP Advances 2021. [PMCID: PMC8500160 DOI: 10.1093/sleepadvances/zpab014.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction Nosocomial transmission of SARS-CoV-2 has caused significant morbidity/mortality in the COVID-19 pandemic. Because patients auto-emit aerosols containing viable virus, these aerosols can be further propagated when patients undergo certain treatments including continuous positive airway pressure (PAP) therapy. This study aimed to assess the degree of viable virus propagated from mask leak in a PAP circuit. Methods Bacteriophage PhiX174 (108copies/mL) was nebulised into a custom PAP circuit. Mask leak was systematically varied to 0, 7, 21, 28 and 42 L/min at the mask interface. Plates containing Escherichia coli assessed the degree of viable virus settling on surfaces around the room. In order to contain virus spread a ventilated headboard and high efficiency particulate air (HEPA) filter was tested. Results Increasing mask leak was associated with virus contamination in a dose response manner (χ2= 58.24, df=4, p<0.001). Clinically relevant levels of leak (≥21 L/min) were associated with virus counts equivalent to using PAP with a standard vented mask. Viable viruses were recorded on all plates (up to 3.86m from source). A plastic hood with HEPA filtration significantly reduced viable viruses on all plates. HEPA exchange rates of 170 and 470m3/hr eradicated all evidence of virus contamination. Discussion Mask leak from PAP circuits may be a major source of environmental contamination and nosocomial spread of infectious respiratory diseases. Subclinical levels of leak should be treated as an infectious risk. Cheap and low-cost patient hoods with HEPA filtration are an effective countermeasure.
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Affiliation(s)
- S Landry
- Department of Physiology, School of Biomedical Sciences & Biomedical Discovery Institute, Monash University, Clayton, Australia
| | - J Barr
- School of Biological Sciences, Monash University, Clayton, Australia
| | - M MacDonald
- Monash Lung Sleep Allergy Immunology, Monash Health, Clayton, Australia
| | - G Hamilton
- Monash Lung Sleep Allergy Immunology, Monash Health, Clayton, Australia
- School of Clinical Sciences, Monash University, Clayton, Australia
| | - D Mansfield
- Monash Lung Sleep Allergy Immunology, Monash Health, Clayton, Australia
| | - B Edwards
- Department of Physiology, School of Biomedical Sciences & Biomedical Discovery Institute, Monash University, Clayton, Australia
| | - S Joosten
- Monash Lung Sleep Allergy Immunology, Monash Health, Clayton, Australia
- School of Clinical Sciences, Monash University, Clayton, Australia
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Cave B, Najafali D, Gilliam W, Barr J, Cain C, Yum C, Palmer J, Tanveer S, Esposito E, Tran Q. 387 Outcome Predictors of Interhospital Transferred Patients to Emergency General Surgery Service: Does Transfer Location Matter? Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Seaton K, Mullens D, Barr J, Hull E, Averitte R. Use of Amniotic Tissue-Derived Allografts Post-Mohs Micrographic Surgery: A Preliminary Study Assessing Wound Closure Rate. Wounds 2021; 33:185-191. [PMID: 34237012 DOI: 10.25270/wnds/2021.185191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION When closure is not feasible, Mohs micrographic surgical wounds typically are left to heal by secondary intention and require weeks to close. Amniotic tissue-derived allograft (ATDA) has proven successful in promoting wound closure in diabetic and refractory wounds, and it may be beneficial for patients who have undergone Mohs micrographic surgery. OBJECTIVE The authors conducted a preliminary study to assess the efficacy of ATDA in speeding wound closure time and improving cosmetic outcomes in the specified patient population. MATERIALS AND METHODS Patients received an injection of amniotic fluid, an overlay of amniotic membrane, or standard of care. Photographs of wounds taken at the time of treatment and at each subsequent visit were analyzed. RESULTS The cosmetic outcome and time to wound closure appeared to be improved in patients treated with ATDA when compared with expected outcomes. Owing to small sample size, differences in initial defect size, and variety of body locations, the wound closure rate between treatment groups was not found to be significantly different with most comparisons. Statistical significance was seen, however, when normalized closure rates between membrane and control intervention were compared after outlier analysis (P = .0288). CONCLUSIONS Data indicate that ATDA treatment may be beneficial and suggest that further investigation of the efficacy of ATDA to promote wound healing and improve cosmetic outcomes of post-Mohs surgical wounds is warranted. Future studies should be designed to match initial defect size and location between control and treatment groups.
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Affiliation(s)
- Kayleen Seaton
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, Arizona
| | - Dustin Mullens
- Affiliated Dermatology & Affiliated Laboratories, Scottsdale, Arizona
| | - Jason Barr
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, Arizona; Affiliated Dermatology & Affiliated Laboratories, Scottsdale, Arizona
| | | | - Richard Averitte
- Arizona College of Osteopathic Medicine, Midwestern University, Glendale, Arizona; Affiliated Dermatology & Affiliated Laboratories, Scottsdale, Arizona
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Eldon D, Wang H, Wang L, Barr J, Ding S, Garofalo A, Gong X, Guo H, Järvinen A, Li K, McClenaghan J, McLean A, Samuell C, Watkins J, Weisberg D, Yuan Q. An analysis of controlled detachment by seeding various impurity species in high performance scenarios on DIII-D and EAST. Nuclear Materials and Energy 2021. [DOI: 10.1016/j.nme.2021.100963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Annand E, Barr J, Singanallur Balasubramanian N, Reid P, Boyd V, Burneikienė-Petraitytė R, Žvirblienė A, Grewar J, Laing E, Secombe C, Britton P, Jones C, Broder C, Dhand N, Smith I. Spillover of bat borne rubulavirus in Australian horses – Horses as sentinels for emerging infectious diseases. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Hahn SH, Han H, Woo M, Bak J, Chung J, Jeon Y, Jeong J, Joung M, Juhn J, Kim H, Kim H, Lee M, Shin G, Tak T, Yoon S, Barr J, Eidietis N, Humphreys D, Hyatt A, Penaflor B, Piglowski D, Walker M, Welander A, Boyer M, Erickson K, Mueller D. Advances and challenges in KSTAR plasma control toward long-pulse, high-performance experiments. Fusion Engineering and Design 2020. [DOI: 10.1016/j.fusengdes.2020.111622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Waters‐Bailey S, McGraw MS, Barr J. Serving the Whole Student: Addressing Nonacademic Barriers Facing Rural Community College Students. ACTA ACUST UNITED AC 2019. [DOI: 10.1002/cc.20372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Pajares A, Wehner W, Schuster E, Eidietis N, Welander A, La Haye R, Ferron J, Barr J, Walker M, Humphreys D, Hyatt A. Integrated current profile, normalized beta and NTM control in DIII-D. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.01.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Affiliation(s)
- C. A. Cruz
- Chevron Phillips Chemical Company LP, Phillips 66 Research Center, Bartlesville, Oklahoma 74003, United States
| | - M. M. Monwar
- Chevron Phillips Chemical Company LP, Phillips 66 Research Center, Bartlesville, Oklahoma 74003, United States
| | - J. Barr
- Chevron Phillips Chemical Company LP, Phillips 66 Research Center, Bartlesville, Oklahoma 74003, United States
| | - M. P. McDaniel
- Chevron Phillips Chemical Company LP, Phillips 66 Research Center, Bartlesville, Oklahoma 74003, United States
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Bagla S, Levy J, Hopkins T, Massari F, Vogel A, Bress A, Dixon R, Mitchell J, Sunenshine P, Barr J, Tran N, Morris J, Berrier H, Brelje T, Schwartz K. Abstract No. 618 Rapid pain improvement in patients treated for painful bone metastases with the Medtronic Osteocool RF Ablation system: the OPuS One study. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Affiliation(s)
- Andrew J Newman
- Dermatology Residency, Affiliated Dermatology, Scottsdale, Arizona, USA
| | - Dustin Mullens
- Dermatology Residency, Affiliated Dermatology, Scottsdale, Arizona, USA
| | - Christine C Lin
- Dermatology Residency, Affiliated Dermatology, Scottsdale, Arizona, USA
| | - Jason Barr
- Dermatology Residency, Affiliated Dermatology, Scottsdale, Arizona, USA
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Manway M, Blackburn S, Barr J, Hull E, Averitte R, Ahn Y. Effects of acupuncture on chronic idiopathic pruritus: an uncontrolled pilot study evaluating inflammatory changes with treatment. J Complement Integr Med 2018; 16:/j/jcim.ahead-of-print/jcim-2018-0021/jcim-2018-0021.xml. [PMID: 30391935 DOI: 10.1515/jcim-2018-0021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 10/04/2018] [Indexed: 11/15/2022]
Abstract
Background Conduct a pilot study addressing the efficacy of acupuncture in the treatment of chronic idiopathic pruritus to aid in the design of a larger clinical trial. Routine laboratory tests to assess systemic inflammation in addition to subjective patient surveys were performed provide documentation of efficacy of treatment. Methods Patients with chronic pruritus who did not respond to standard treatment were recruited to participate. After exclusion of systemic or known reversible causes, each patient received up to 10 treatments which were performed approximately one week apart. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured before and after a series of acupuncture treatments to evaluate levels of inflammation and pre- and post-treatment surveys were conducted to evaluate levels of perceived itch. Results Only one of the ten patients in this study possessed an elevation of ESR before treatment. This patient's ESR value returned to normal range after treatment and this participant reported subjective relief of her pruritus. Conclusions Future studies on the efficacy of acupuncture in the treatment of chronic idiopathic pruritus should focus on those patients with measurable levels of inflammation at the initiation of the study or utilize alternative and more comprehensive values to monitor disease response.
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Affiliation(s)
- Mitchell Manway
- Affiliated Dermatology & Affiliated Laboratories, Midwestern University Osteopathic Postdoctoral Training Institute, Scottsdale, AZ, USA
| | - Stephanie Blackburn
- Affiliated Dermatology & Affiliated Laboratories, Midwestern University Osteopathic Postdoctoral Training Institute, Scottsdale, AZ, USA
| | - Jason Barr
- Affiliated Dermatology & Affiliated Laboratories, Midwestern University Osteopathic Postdoctoral Training Institute, Scottsdale, AZ, USA
| | - Elizabeth Hull
- Biomedical Sciences Program, College of Graduate Studies, Midwestern University, 19555 N 59Avenue, Glendale, AZ 85308, USA
| | - Richard Averitte
- Affiliated Dermatology & Affiliated Laboratories, Midwestern University Osteopathic Postdoctoral Training Institute, Scottsdale, AZ, USA
| | - Yang Ahn
- Medical Acupuncture, Ahn Clinic, Scottsdale, AZ, USA
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Affiliation(s)
- Andrew J Newman
- Dermatology Residency, Affiliated Dermatology, Scottsdale, Arizona, USA
| | - Andrea Schneider
- College of Osteopathic Medicine, Midwestern University, Glendale, Arizona, USA
| | - Brooke Blumetti
- Dermatology Residency, Affiliated Dermatology, Scottsdale, Arizona, USA
| | - Jason Barr
- Dermatology Residency, Affiliated Dermatology, Scottsdale, Arizona, USA
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Abstract
Cutaneous angioleiomyomas (ALMs) are uncommon benign tumours of the skin which derive from the smooth muscle layer of dermal blood vessels. They usually present as tender nodules in the fifth or sixth decade of life, predominantly in the legs of females. These tumours rarely present on the head and neck, especially the ear. Head and neck ALMs differ from their more common leg counterparts in that they are painless. Additionally, they do not manifest with a female predominance. Herein, a new case of a painless auricular ALM in a 63-year-old man is reported.
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Affiliation(s)
- Andrew J Newman
- Dermatology Residency, Affiliated Dermatology, Scottsdale, Arizona, USA
| | - Dustin Mullens
- Dermatology Residency, Affiliated Dermatology, Scottsdale, Arizona, USA
| | - Sarah Estrada
- Dermatology Residency, Affiliated Dermatology, Scottsdale, Arizona, USA
| | - Jason Barr
- Dermatology Residency, Affiliated Dermatology, Scottsdale, Arizona, USA
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Newman AJ, Mullens D, Manway M, Barr J. Red, white and blues: Darier disease and mood disorder. BMJ Case Rep 2018; 2018:bcr-2018-227004. [DOI: 10.1136/bcr-2018-227004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Chandra RV, Maingard J, Asadi H, Slater LA, Mazwi TL, Marcia S, Barr J, Hirsch JA. Vertebroplasty and Kyphoplasty for Osteoporotic Vertebral Fractures: What Are the Latest Data? AJNR Am J Neuroradiol 2018; 39:798-806. [PMID: 29170272 DOI: 10.3174/ajnr.a5458] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Osteoporotic vertebral compression fractures frequently result in significant morbidity and health care resource use. For patients with severe and disabling pain, vertebral augmentation (vertebroplasty and kyphoplasty) is often considered. Although vertebroplasty was introduced >30 years ago, there are conflicting opinions regarding the role of these procedures in the treatment of osteoporotic vertebral compression fractures. This review article updates clinicians on the published prospective randomized controlled data, including the most recent positive trials that followed initial negative trials in 2009. Analysis of multiple national claim datasets has also provided further insight into the utility of these procedures. Finally, we considered the recent recommendations of national organizations and medical societies that advise on the use of vertebral augmentation procedures for osteoporotic vertebral compression fractures.
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Affiliation(s)
- R V Chandra
- From the Interventional Neuroradiology Unit (R.V.C., H.A., L.-A.S.), Monash Imaging, Monash Health, Melbourne, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences (R.V.C., L.-A.S.), Monash University, Melbourne, Victoria, Australia
| | - J Maingard
- Interventional Neuroradiology Service (J.M., H.A.), Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia
| | - H Asadi
- From the Interventional Neuroradiology Unit (R.V.C., H.A., L.-A.S.), Monash Imaging, Monash Health, Melbourne, Victoria, Australia
- Interventional Neuroradiology Service (J.M., H.A.), Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia
- School of Medicine, Faculty of Health (H.A.), Deakin University, Waurn Ponds, Victoria, Australia
| | - L-A Slater
- From the Interventional Neuroradiology Unit (R.V.C., H.A., L.-A.S.), Monash Imaging, Monash Health, Melbourne, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences (R.V.C., L.-A.S.), Monash University, Melbourne, Victoria, Australia
| | - T-L Mazwi
- Neuroendovascular Program (T.-L.M., J.A.H.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - S Marcia
- Department of Radiology (S.M.), SS. Trinità Hospital, Cagliari, Italy
| | - J Barr
- Interventional Neuroradiology (J.B.), University of Texas Southwestern Medical Center, Dallas, Texas
| | - J A Hirsch
- Neuroendovascular Program (T.-L.M., J.A.H.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Barr J, Schwarz P. Malt Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-2009-0624-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Barley Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-2007-0710-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Barley Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-59-0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Barley Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-62-0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Barley Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-63-0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Malt Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-62-0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Barley Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-60-0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Barley Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-61-0169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Malt Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-59-0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Malt Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-58-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Malt Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-60-0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Barley Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-2008-0722-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Barley Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-64-0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Malt Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-2008-0724-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Malt Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-61-0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Malt Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-63-0146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Malt Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-64-0179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Barley Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-2009-0622-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Malt Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-2007-0711-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Schwarz P. Barley Analysis Check Service. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-58-0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ogden K, Barr J, Greenfield D. ISQUA17-2215A CONCEPTUAL MAP FOR PATIENT-CENTRED CARE REQUIREMENTS: ENHANCING THE APPROACH OF SYSTEMS TO ACHIEVING PATIENT-CENTRED CARE. Int J Qual Health Care 2017. [DOI: 10.1093/intqhc/mzx125.65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Jennings J, Robinson C, Wallace A, Howard C, Brower J, Sayed D, Tran N, Vrionis F, Lekht I, Chang E, Bagla S, Papadouris D, Vadlamudi V, Meyer J, Timmerman R, Barr J, Chason D, Sichlau M, Sewall L, So G, Baek D, Tutton S, Lea W, Morris J, Callstrom M. Prospective, multicenter evaluation of targeted radiofrequency ablation (t-RFA) and vertebral augmentation (VA) prior to or following radiation therapy (RT) to treat painful metastatic vertebral body tumors (STARRT Study): Interim analysis. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Epstein J, Anthony S, Islam A, Kilpatrick A, Khan SA, Ross N, Smith I, Barr J, Zambrana-Torrelio C, Tao Y, Islam A, Quan P, Olival K, Gurley E, Hossain M, Field H, Fielder M, Briese T, Rahman M, Crameri G, Wang LF, Luby S, Lipkin W, Daszak P. Nipah virus ecology and infection dynamics in its bat reservoir, Pteropus medius, in Bangladesh. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.11.056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Bohannon JK, Janosko K, Holbrook MR, Barr J, Pusl D, Bollinger L, Coe L, Hensley LE, Jahrling PB, Wada J, Kuhn JH, Lackemeyer MG. Safety Precautions and Operating Procedures in an (A)BSL-4 Laboratory: 3. Aerobiology. J Vis Exp 2016. [PMID: 27768036 DOI: 10.3791/53602] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Aerosol or inhalational studies of high-consequence pathogens have recently been increasing in number due to the perceived threat of intentional aerosol releases or unexpected natural aerosol transmission. Specific laboratories designed to perform these experiments require tremendous engineering controls to provide a safe and secure working environment and constant systems maintenance to sustain functionality. Class III biosafety cabinets, also referred to as gloveboxes, are gas-tight enclosures with non-opening windows. These cabinets are maintained under negative pressure by double high-efficiency-particulate-air (HEPA)-filtered exhaust systems and are the ideal primary containment for housing aerosolization equipment. A well planned workflow between staff members within high containment from, for instance, an animal biosafety level-4 (ABSL-4) suit laboratory to the ABSL-4 cabinet laboratory is a crucial component for successful experimentation. For smooth study execution, establishing a communication network, moving equipment and subjects, and setting up and placing equipment, requires staff members to meticulously plan procedures prior to study initiation. Here, we provide an overview and a visual representation of how aerobiology research is conducted at the National Institutes of Health, National Institute of Allergy and Infectious Diseases Integrated Research Facility at Fort Detrick, Maryland, USA, within an ABSL-4 environment.
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Affiliation(s)
- J Kyle Bohannon
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Krisztina Janosko
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Michael R Holbrook
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Jason Barr
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Daniela Pusl
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Laura Bollinger
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Linda Coe
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Lisa E Hensley
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Peter B Jahrling
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Jiro Wada
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Jens H Kuhn
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH);
| | - Matthew G Lackemeyer
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
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Mazur S, Holbrook MR, Burdette T, Joselyn N, Barr J, Pusl D, Bollinger L, Coe L, Jahrling PB, Lackemeyer MG, Wada J, Kuhn JH, Janosko K. Safety Precautions and Operating Procedures in an (A)BSL-4 Laboratory: 2. General Practices. J Vis Exp 2016. [PMID: 27768081 DOI: 10.3791/53600] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Work in a biosafety level 4 (BSL-4) containment laboratory requires time and great attention to detail. The same work that is done in a BSL-2 laboratory with non-high-consequence pathogens will take significantly longer in a BSL-4 setting. This increased time requirement is due to a multitude of factors that are aimed at protecting the researcher from laboratory-acquired infections, the work environment from potential contamination and the local community from possible release of high-consequence pathogens. Inside the laboratory, movement is restricted due to air hoses attached to the mandatory full-body safety suits. In addition, disinfection of every item that is removed from Class II biosafety cabinets (BSCs) is required. Laboratory specialists must be trained in the practices of the BSL-4 laboratory and must show high proficiency in the skills they are performing. The focus of this article is to outline proper procedures and techniques to ensure laboratory biosafety and experimental accuracy using a standard viral plaque assay as an example procedure. In particular, proper techniques to work safely in a BSL-4 environment when performing an experiment will be visually emphasized. These techniques include: setting up a Class II BSC for experiments, proper cleaning of the Class II BSC when finished working, waste management and safe disposal of waste generated inside a BSL-4 laboratory, and the removal of inactivated samples from inside a BSL-4 laboratory to the BSL-2 laboratory.
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Affiliation(s)
- Steven Mazur
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Michael R Holbrook
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Tracey Burdette
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Nicole Joselyn
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Jason Barr
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Daniela Pusl
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Laura Bollinger
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Linda Coe
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Peter B Jahrling
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Matthew G Lackemeyer
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Jiro Wada
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Jens H Kuhn
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH);
| | - Krisztina Janosko
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
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Byrum R, Keith L, Bartos C, St Claire M, Lackemeyer MG, Holbrook MR, Janosko K, Barr J, Pusl D, Bollinger L, Wada J, Coe L, Hensley LE, Jahrling PB, Kuhn JH, Lentz MR. Safety Precautions and Operating Procedures in an (A)BSL-4 Laboratory: 4. Medical Imaging Procedures. J Vis Exp 2016. [PMID: 27768056 DOI: 10.3791/53601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Medical imaging using animal models for human diseases has been utilized for decades; however, until recently, medical imaging of diseases induced by high-consequence pathogens has not been possible. In 2014, the National Institutes of Health, National Institute of Allergy and Infectious Diseases, Integrated Research Facility at Fort Detrick opened an Animal Biosafety Level 4 (ABSL-4) facility to assess the clinical course and pathology of infectious diseases in experimentally infected animals. Multiple imaging modalities including computed tomography (CT), magnetic resonance imaging, positron emission tomography, and single photon emission computed tomography are available to researchers for these evaluations. The focus of this article is to describe the workflow for safely obtaining a CT image of a live guinea pig in an ABSL-4 facility. These procedures include animal handling, anesthesia, and preparing and monitoring the animal until recovery from sedation. We will also discuss preparing the imaging equipment, performing quality checks, communication methods from "hot side" (containing pathogens) to "cold side," and moving the animal from the holding room to the imaging suite.
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Affiliation(s)
- Russell Byrum
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Lauren Keith
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Christopher Bartos
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Marisa St Claire
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Matthew G Lackemeyer
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Michael R Holbrook
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Krisztina Janosko
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Jason Barr
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Daniela Pusl
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Laura Bollinger
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Jiro Wada
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Linda Coe
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Lisa E Hensley
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Peter B Jahrling
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Jens H Kuhn
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH);
| | - Margaret R Lentz
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
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Janosko K, Holbrook MR, Adams R, Barr J, Bollinger L, Newton JT, Ntiforo C, Coe L, Wada J, Pusl D, Jahrling PB, Kuhn JH, Lackemeyer MG. Safety Precautions and Operating Procedures in an (A)BSL-4 Laboratory: 1. Biosafety Level 4 Suit Laboratory Suite Entry and Exit Procedures. J Vis Exp 2016. [PMID: 27768063 PMCID: PMC5092084 DOI: 10.3791/52317] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Biosafety level 4 (BSL-4) suit laboratories are specifically designed to study high-consequence pathogens for which neither infection prophylaxes nor treatment options exist. The hallmarks of these laboratories are: custom-designed airtight doors, dedicated supply and exhaust airflow systems, a negative-pressure environment, and mandatory use of positive-pressure (“space”) suits. The risk for laboratory specialists working with highly pathogenic agents is minimized through rigorous training and adherence to stringent safety protocols and standard operating procedures. Researchers perform the majority of their work in BSL-2 laboratories and switch to BSL-4 suit laboratories when work with a high-consequence pathogen is required. Collaborators and scientists considering BSL-4 projects should be aware of the challenges associated with BSL-4 research both in terms of experimental technical limitations in BSL-4 laboratory space and the increased duration of such experiments. Tasks such as entering and exiting the BSL-4 suit laboratories are considerably more complex and time-consuming compared to BSL-2 and BSL-3 laboratories. The focus of this particular article is to address basic biosafety concerns and describe the entrance and exit procedures for the BSL-4 laboratory at the NIH/NIAID Integrated Research Facility at Fort Detrick. Such procedures include checking external systems that support the BSL-4 laboratory, and inspecting and donning positive-pressure suits, entering the laboratory, moving through air pressure-resistant doors, and connecting to air-supply hoses. We will also discuss moving within and exiting the BSL-4 suit laboratories, including using the chemical shower and removing and storing positive-pressure suits.
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Affiliation(s)
- Krisztina Janosko
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Michael R Holbrook
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Ricky Adams
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Jason Barr
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Laura Bollinger
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Je T'aime Newton
- Environmental Health and Safety, Biological and Chemical Safety Program, University of Texas Medical Branch
| | - Corrie Ntiforo
- Environmental Health and Safety, Biological and Chemical Safety Program, University of Texas Medical Branch
| | - Linda Coe
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Jiro Wada
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Daniela Pusl
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Peter B Jahrling
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
| | - Jens H Kuhn
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH);
| | - Matthew G Lackemeyer
- Integrated Research Facility at Frederick, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH)
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McDougall C, Beecher J, Shen Ban V, Fiesta M, Barr J, White J, Novakovic R, Pride G, Welch B. E-072 50 Shades of Gradients: Does the Pressure Gradient in Venous Sinus Stenting for Idiopathic Intracranial Hypertension Matter? J Neurointerv Surg 2016. [DOI: 10.1136/neurintsurg-2016-012589.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barr J, Ogden K, Rooney K. Building the community of patient-centred care practice across all sectors of health care and health professional education. Intern Med J 2016; 46:122-3. [PMID: 26813909 DOI: 10.1111/imj.12932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 08/18/2015] [Indexed: 12/01/2022]
Affiliation(s)
- J Barr
- School of Medicine, University of Tasmania, Launceston, Tasmania, Australia.
| | - K Ogden
- School of Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - K Rooney
- School of Medicine, University of Tasmania, Launceston, Tasmania, Australia
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Olufemi O, Umoh J, Dzikwi A, Wang L, Crameri G, Morrissy C, Barr J, Olufemi Y. Serological evidence of henipavirus among horses and pigs in Zaria and environs, Kaduna State Nigeria. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Fiesta M, Atchie B, Mehta N, Barr J, Novakovic R, Welch B, White J, Rickert K, Zide M, Tiwana P, Pride G. E-027 high volume dual lumen balloon catheter onyx embolization of a large mandibular venous lake associated with a hemorrhagic intraosseous mandibular arteriovenous malformation. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Barr J, Boulind C, Foster JD, Ewings P, Reid J, Jenkins JT, Williams-Yesson B, Francis NK. Impact of analgesic modality on stress response following laparoscopic colorectal surgery: a post-hoc analysis of a randomised controlled trial. Tech Coloproctol 2015; 19:231-9. [PMID: 25715786 DOI: 10.1007/s10151-015-1270-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 01/27/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Epidural analgesia is perceived to modulate the stress response after open surgery. This study aimed to explore the feasibility and impact of measuring the stress response attenuation by post-operative analgesic modalities following laparoscopic colorectal surgery within an enhanced recovery after surgery (ERAS) protocol. METHODS Data were collected as part of a double-blinded randomised controlled pilot trial at two UK sites. Patients undergoing elective laparoscopic colorectal resection were randomised to receive either thoracic epidural analgesia (TEA) or continuous local anaesthetic infusion to the extraction site via wound infusion catheter (WIC) post-operatively. The aim of this study was to measure the stress response to the analgesic modality by measuring peripheral venous blood samples analysed for serum concentrations of insulin, cortisol, epinephrine and interleukin-6 at induction of anaesthesia, at 3, 6, 12 and 24 h after the start of operation. Secondary endpoints included mean pain score in the first 48 h, length of hospital stay, post-operative complications and 30-day re-admission rates. RESULTS There was a difference between the TEA and WIC groups that varies across time. In the TEA group, there was significant but transient reduced level of serum epinephrine and a higher level of insulin at 3 and 6 h. In the WIC, there was a significant reduction of interleukin-6 values, especially at 12 h. There was no significant difference observed in the other endpoints. CONCLUSIONS There is a significant transient attenuating effect of TEA on stress response following laparoscopic colorectal surgery and within ERAS as expressed by serum epinephrine and insulin levels. Continuous wound infusion with local anaesthetic, however, attenuates cytokine response as expressed by interleukin-6.
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Affiliation(s)
- J Barr
- Yeovil District Hospital Foundation, Higher Kingston, Yeovil, Somerset, BA21 4AT, UK
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